Streaming video network system

ABSTRACT

A distributed, digital, network-based, streaming video solution allows users to view live streaming digital video from multiple video sources in multiple operating rooms at any location connected to a network. One or more video sources in an operating room are connected to a streaming video encoder capable of converting the video to a network packet stream. Once the digital video stream is available on the network, it may be accessed and routed through the use of a streaming video control server. The streaming video control server is responsible for user authentication and authorization and web page access for remote viewing and video source selection by users. The control server also provides audit logging services, operating room selection and overall system resource allocation. The video control server also provides a network-based remote control interface, which enables other systems to communicate on the streaming video network, and allows for remote control of visualization from an integrated operating room control system, and provides the ability for one operating room to look into other operating rooms.

RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application No.60/710,886, filed on Aug. 24, 2005.

FIELD OF THE INVENTION

The invention relates generally to the streaming of digital video andaudio over data networks, where the source originates from medicalclinical or surgical procedures, where remote visualization is requiredfrom other locations, such as operating rooms, offices or conferencerooms, where remote selection and control of video sources may berequired, and where HIPAA compliance enabling features are needed.

BACKGROUND OF THE INVENTION

With the development and practice of Minimally Invasive Surgical (MIS)technique, has come a proliferation of medical and non-medical devicesthat generate video in the hospital operating room and in medicalclinics. The term MIS is used to describe a number of surgeries as wellas diagnostic procedures. MIS includes both laparoscopy (surgery throughsmall holes) and endoscopy (diagnostic and therapeutic proceduresperformed through the body's organs and vessels). In traditionalsurgeries, a surgeon needs to make a large incision in order to operate.With MIS, the surgeon makes a few small holes—usually less than ½ aninch. The surgeon then inserts specially designed, thin instruments andsophisticated video equipment to perform the operation through thesmaller opening. The small incisions required for MIS generate lesspain, reduces hospital stays, cause less scarring and facilitate rapidrecovery. A common element of MIS procedures is that a video camera anda monitor is required for the surgeon to visualize the operative field.By using video-assisted equipment, the surgeon has better visualizationand magnification of internal organs and structure. Since the operativefield monitor can be seen by support staff inside the operating room,awareness of the surgical procedure is improved and the staff is betterable to support the surgeon. Several other sources of video haverecently emerged in the operating room including cameras attached tosurgical microscopes, cameras mounted inside surgical lights andpan/zoom/tilt cameras mounted to walls inside the operating room.

Integrated Operating Room (IOR) technology has been developed andvisualization tools are emerging and evolving to assist medicalprofessionals with the management of this video and equipment within theoperating room. Given that current art video cameras for the operatingroom environment output an analog signal, that these cameras typicallyare used for several years, and that analog video connections such ass-video and composite are well known and understood in the art, IORtechnology inside the operating room routes analog video signalsexclusively with rare exception.

Outside the operating room, a need has emerged for viewing live videofrom cameras located inside the operating room. Physicians who arescheduled to perform a procedure in an operating room will often want tocheck on the readiness of the staff and the patient prior to walkinginto the operating room theatre. With remote viewing capability, thephysician has the ability to confirm ‘first hand’ the readiness of thestaff and patient. Furthermore, a peer, fellow or resident may desire orrequire assistance with a procedure. Again, the physician is notrequired to enter the operating room, or operating theater, thusreducing the need to travel to the operating room, dress in scrubs, andsometimes scrub into a procedure. Another example of this need involvesintra-procedure consultation between operating rooms in which a surgeonrequests a second opinion from peer surgeons located in other operatingrooms within the preoperative services department. This type ofconsultation requires that an on-demand video conference be establishedbetween operating rooms in which both video and audio can be shared. Yetanother example of this need involves real-time collaboration betweenpathology and the operating room in which the surgeon can show thepathologist video indicating from where a cancer biopsy was taken. Thearea of staff and student training is another area that benefitssignificantly from the ability to view high-quality live-video outsidethe operating room. Students and additional staff do not need to bepresent in the operating room, causing crowding, and potentialdistractions for the surgeon. Rather, they can be at a conference roomlocation, or distributed at a variety of locations across the hospitalcampus.

Another example of this need is for nurse management to have visibilityinto operating room so that scheduling and resource management may befacilitated. An additional element of this need is that the nursemanagement would like to have visibility into several roomssimultaneously. The ability to remotely observe operating rooms has beenshown to improve staff scheduling, room turnover and room cleaningtimes. Access to this type of remote visualization toolset has thepotential to improve efficiency and save time for both physician andnon-physician caregivers.

Consistent with the type of technology used for IOR solutions, currentart systems view video outside the operating room through the use ofanalog video cable infrastructure. Although the video quality of analogsystems is generally adequate for current art cameras, this approach hasseveral key limitations:

-   -   The number of users served by this solution is limited, because        hard-wired video signals must be brought to each ‘user’    -   The number of locations that can be served by this solution is        equally so limited.    -   Wide-scale deployment of this solution is severely limited in        all but new construction, due to the extensive cable        infrastructure that must be installed.    -   Dedicated viewing hardware, analog switching equipment and        displays are often required in order to complete the solution.    -   Distance limitations exist for video that must be addressed by        expensive fiber-optic transmission equipment.    -   Usage and viewing of this video is extremely difficult, if not        impossible to track.    -   The solution is not easily scalable to add more locations or        more sources at a given location.    -   The cost of installing and maintaining the dedicated video cable        infrastructure is high.

It is also important to note that the ability to remotely view a singlevideo source of video from inside the operating room (OR) is generallyinadequate. Depending on the type of operation being performed and thenumber of surgical modalities being employed, the remote viewer may needto see video from multiple sources such as the OR room camera, surgicallight camera, microscopic camera or the endoscopic camera. Accordingly,the remote viewer requires the ability to switch remotely between thesource video modalities until the proper view is selected.

Exemplary Operation

As digital video compression and video streaming technologies havedeveloped, they have become capable of offering high-quality video withlow-bandwidth consumption on Ethernet data networks. This has made thetechnology a viable and useful alternative to the hard-wired approaches,while offering substantially more flexibility. Some examples include:

A virtually limitless number of users and locations can besimultaneously served.

Dedicated viewing stations are not required.

Viewing can be accomplished on any standard ‘Windows’ computer with theproper configuration and network connectivity.

Viewing is also possible on non Windows platforms, such as Apple MACusing open source applications.

Digital streaming video can be viewed anywhere in the hospital, on thehospital campus, or via wide area broadband connections off the hospitalcampus.

Smart digital video walls can be constructed and fed by embedded videodecoding hardware.

Users may take advantage of the ability to remotely control certaindevices, such as Pan/Zoom/Tilt (PZT) cameras.

Users may take advantage of the ability to select and view video from amultitude of devices in the operating room via remote selectioncapabilities.

Authorization and authentication controls, audit trails, and auto-logofffunctions can be employed, to protect and track access to live content.

Content can be accessed over standard Ethernet networks, with firewalland VPN encryption capabilities.

The systems and methods described herein are unique relative to thetraditional broadcast service offerings, in that this solution becomespart of the hospital's infrastructure and does not require a staff ofprofessionals to operate. As such, it is effectively owned and operatedby the staff, and does not require extensive training to use. Dependingon local network policy, the system may be configured for one-to-one(unicast) or one-to-many (multicast) transmissions. Being part of thehospital operating room infrastructure, the system is always ready andavailable for use.

Accordingly, there is a need in the art for a system that affordssurgeons and medical professionals remote access to live video generatedin hospital operating rooms and clinics. Such system should offerflexibility in the format, transport medium, and viewing location of thedigital video streams. The system must also offer security and auditingcapabilities.

SUMMARY OF THE INVENTION

It is an objective of the invention to improve operating room, staff andsurgeon efficiency by providing live remote access to video whichoriginates in hospital operating rooms and clinics. It is a furtherobject of the present invention to increase the level of control thatusers can leverage over the video sources at the originating location.It is an added object of the invention to increase the potentialaudience and number of locations from which live-video can be accessed,such as operating rooms, offices, conference rooms and video walls toname a few. It is also an object of the current invention to offer anadequate level of auditing and security controls to assist hospitals intheir need to be HIPAA compliant.

The present invention achieves these and other objectives by providing adistributed, digital, network-based, streaming video solution thatallows users to view live operating room video from virtually anylocation that is connected to a network. One or more video sources in anoperating room may be connected to a device (streaming video encoder)capable of converting the video to a network packet stream. Once thedigital video stream is available on the network, it may be accessed androuted through the use of a streaming video control server. Thestreaming video control server is responsible for user authenticationand authorization and web page access for remote viewing and videosource selection by users. The control server also provides auditlogging services, operating room selection and overall system resourceallocation. The video control server also provides a network-basedremote control interface, which enables other systems to communicate onthe streaming video network. This allows for remote control ofvisualization from an integrated operating room control system (forexample: Crestron or AMX) and provides the ability for one operatingroom to look into other operating rooms.

In accordance with one general aspect of the invention, a user interfaceis provided that is accessible via standard web-browser technology froma personal computer. This embodiment includes a familiar, user-friendlyinterface to provide access to the desired services. To begin a viewingsession, the user opens a browser, and navigates to the appropriate URL(such as http://imagestream/lsp), and is presented with a login page. Togain access to the system, the user must enter their username andpassword. Once the user has been authenticated, they are granted accessto the list of available operating rooms with specialties that matchthose of the user. The user is then able to select from any of theavailable operating rooms for live viewing. Once the link for thedesired operating room has been selected, the viewing and control pageis presented. A sample viewing page is presented below.

The user is presented with a live video view of the operating room, orsome alternate view, as shown in the center of the screen sample. Theuser is optionally provided with video device selection buttons (left)which allow selection of alternate video sources that are located withinthe operating room. Advanced users may be granted control over certaincontrollable OR cameras, such as Pan/Zoom/Tilt or Surgical LightCameras. When the operating room is selected, a programmable sessiontimer is activated, which will automatically log the user out of thesession, once the time expires. Five minutes prior to the expiration ofthe viewing session, users are allowed to extend their viewing session.

Administrative services are provided for the purpose of system setup, aswell as system usage monitoring, user setup, room privacy controls, andsystem diagnostics.

In accordance with another aspect of the present invention, there isprovided a streaming digital video control server (4), whichincorporates a network control linkage to a video switching system (2)located in or near the operating room. To the switching system (2) maybe connected a multitude of surgical and non-surgical video devices (1)in a video operating room. In this configuration, one or more videostreaming devices (3) (where a video streaming device converts video topacket-based network digital video stream) may be connected to theoutput of the video switching system and to the hospital data network(5). Users may access the streaming server and managed video streamsfrom office PCs (7) or from other remote locations. All devices areregistered with the streaming video control server, which has beendesigned to control video streams from a multitude of video streamingdevices and formats.

And in another aspect of the invention, there is provided a system forstreaming digital video over a data network, where the user has theability to remotely control selected devices in the operating room.Devices of this category include, but are not limited to PZT cameras, aswell as cameras embedded in surgical lights. While the user is viewinglive video from one of these devices, they may control certain functionsof the device.

Another aspect of the invention allows for the use of streaming videodecoder devices, which are capable of receiving digital video streamsand converting them to the original analog video or displayable digitalsignal format. Current art integrated operating systems typicallyutilize analog video switching systems, and therefore, these decoderdevices are required to allow virtual video circuit connections to beestablished between operating rooms, or between operating rooms andconference rooms (as examples). The system allows for the creation ofdigital connections, but is dependent on available technology andoperating room capabilities. The system architecture is flexible andwill accommodate both analog and digital devices. Using analog anddigital streaming video decoder technology within this aspect of theinvention allows for the creation of a video wall, which can be used tosimultaneously monitor all operating room locations.

A further aspect of the invention enables the transmission of pathologyimages onto the digital streaming network. Pathology images can bereceived and viewed at any of the locations serviced by the digitalstreaming network. Most importantly, pathology images can be viewed fromwithin an operating room, saving valuable time that would be required towalk to and from pathology, and avoiding the sterility problem ofsurgeons having to exit and re-enter the sterile field.

In another aspect of the current invention, state and status metadatainformation is captured from the source operating room simultaneouslywith the video. The metadata is conveyed using one of several techniquesso that users may view the information in conjunction with the video atthe viewing location. Examples include the ability to combine operatingroom state information with video being displayed on a video wall.Another example includes the ability to collect and transmit patientvital signs information, which is overlaid onto the video as it is beingviewed.

These and other aspects of the invention are herein described in detail,with reference to certain preferred and alternate embodiments which areillustrative but not exclusive of various ways in which the principlesand concepts of the invention can be embodied and practiced.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features and advantages of the present inventionwill become apparent to those skilled in the art to which the presentinvention relates upon reading the following description with referenceto the accompanying drawings, in which:

FIG. 1 is a schematic diagram of an analog video distribution ‘hub’which is commonly used by vendors in the medical/surgical videointegration business.

FIG. 2 is a schematic diagram of a mixed analog/digital videodistribution ‘hub’ which was developed as a prototype iteration of theinvention.

FIG. 3 is a schematic diagram that demonstrates many aspects of thecurrent invention as a complete digital streaming infrastructure systemused for linking video/audio from operating rooms to multiple otherlocations, virtually without limit.

FIG. 4 is a logical operating room to operating room connection diagram.

FIG. 5 is a logical OR to OR to Conference connection diagram.

FIG. 6 is a logical OR/Office connection diagram.

FIG. 7 is a diagram which describes one point-to-point video/audiocommunication scenario.

FIG. 8 is a diagram which describes the addition of metadata deliveryand display to the digital video streaming system.

DETAILED DESCRIPTION OF PREFERRED AND ALTERNATE EMBODIMENTS

FIG. 1 is a schematic diagram of an analog video distribution system(hub) which enables OR to OR and Limited OR to Office visualization.Operating room video sources (1) may be connected to a video switch (2)located in or near the operating room. The video switch is controlled bya video switch controller (3). Video may alternatively be connecteddirectly to the outbound video links 12, which are typically coaxialvideo cable linked back to a central hub location (6), and connected toa central video switch (4). The central video switch is controlled by avideo switch controller (5). Video cabling, again typically coaxialcable (10), is run from the hub location (6) to viewing locations suchas doctor's offices in the same building (11). For longer distances,fiber/copper transceivers (7, 8) are required, along with fiberinfrastructure, in order for users in other buildings to view OR video.Dedicated monitors M at the remote viewing locations are used tovisualize the video. Remote switching control is possible if the user isprovided with a more advanced control system at the remote viewinglocation.

FIG. 2 is a schematic diagram of a mixed analog/digital videodistribution network system which has similar capabilities andlimitations of the system described with reference to FIG. 1, with theadvantages of digital video streaming from a hub location, as furtherdescribed. Multiple operating room video sources (1) are connected to avideo switching system (22), under direct or indirect control of acontrol system (23). Outputs from the video switch (22) are linked to acentral video switch (24), under direct or indirect control of a videocontrol system (25). Video outputs from the central video switch (24)are connected to a bank (1 or more) of streaming video devices (26)(video encoders). It is the job of each streaming video device toconvert the incoming video into a stream of digital video packets, andoutput those packets onto a standards-based Ethernet network andultimately through an Ethernet switch (27). Once the video has been madeavailable on the Ethernet it may be accessed via appropriatelyconfigured office computers (210), via the hospital network backbone(29). The streaming video control server (28) is responsible fororchestrating a multitude of operations in order to allow the viewingprocess to take place. A video wall (212) may be fed directly from thecentral video switch (24).

Users access video from this configuration using an office PC (210)through the use of a standard web browser. When the user first accessesthe services of the streaming digital video network system, they arepresented with a series of web pages, which are served from thestreaming video web server (28).

This embodiment provides user access at virtually unlimited locations toview streaming video. The system requires analog video cabling betweenoperating rooms and the hub location. This approach may be a relativelyexpensive solution for remote OR visualization due to the cost of thededicated video infrastructure required.

FIG. 3 is a schematic diagram of streaming digital video system thatdemonstrates many aspects of the current invention in the form of acomplete digital streaming infrastructure system used for linkingvideo/audio from operating rooms to multiple other locations, virtuallywithout limit. In this embodiment, video sources (1) within theoperating room may be connected to a video switching device or system(32) under control of a switch controller (33). Output from theswitching device is routed to one or more IP streaming video devices(34), which in turn, are connected by a standard data network (Ethernetor similar) to a network switch (36), typically located in a data closet(39). The streaming digital video control server (310) orchestratesaccess to the entire collection of devices which comprises the solution.For PC based users (312) residing in local and remote locations, theweb-browser interface is used for visualizing operating room video overthe hospital backbone (311).

Users in the operating room will use the integrated control system(switch controller) control interface (typically a touch panel) toaccess video from remote operating rooms. Video decoders (35) arelocated in proximity and connected to the video matrix switch (32)located in each operating room. This enables video from one operatingroom to be displayed in another. This further enables the remote videoto be routed by the video switching system (32) to displays in the localoperating room.

With this embodiment, video decoders (37) are used in conjunction with avideo wall (38), which enables staff to simultaneously visualize videofrom all operating rooms. Because the content is digital, the videodecoders can be controlled to show the current state of an operatingroom (i.e., privacy mode enabled, using microscope, etc).

An additional configuration of the invention allows the use of remotevideo encoders and decoders at locations such as conference rooms (313).In this configuration, video from a camera (315) is encoded onto thenetwork (314) and made available for remote visualization anywhere onthe network. In addition, a video decoder (316) consumes digital videostreams from the network, and converts them into a displayable format,suitable for display on a monitor or projector (317).

A system administrator (318) is fully capable of configuring the systemto support these modes of operation, and may dynamically establishbidirectional video/audio sessions between locations, such as an OR anda conference room.

Other locations, such as pathology (320) can be incorporated into thedigital streaming network, by outfitting one or more microscopes (321)with a video camera and streaming video encoder (322) device. The videoencoder, as usual, is connected to the hospital's Ethernet data network.Just as with other viewers of the system, Pathologists nay use astandard PC to access and view the digital streaming video network. Thepathology connection enables a physician to directly view what thepathologist sees in the microscope eliminating the need for thephysician to go to pathology, or for a runner to bring photographs tosurgery. Furthermore, the pathologist may directly view the surgicalfield where the specimen was extracted.

FIGS. 4 and 5 illustrate a sampling of possible connection andcommunication scenarios presented as logical block diagrams. These arenot exhaustive, but presented for the purpose of clarification andexplanation of the system designs. FIG. 4 shows the logicalbi-directional connection and information flow between two operatingrooms, OR1, OR2.

In one scenario, a user in OR1 may simply view video/audio from OR2. Inmore complex configurations, users may communicate over thebi-directional link using video and audio. The current invention fullysupports these capabilities.

FIG. 5 shows the logical bi-directional connection and information flowbetween a conference room and one or more operating rooms. In thisscenario, a single operating room may establish a connection with aconference or control room. The sequence may also be initiated from theconference or control room. In all cases, a unidirectional orbidirectional audio/video link may be established between the twolocations. A user at a location may also request view-only services.

FIG. 6 represents connectivity of a user in an office viewing video from1 or more operating rooms. In this configuration, information flows fromeach OR (OR1, OR2) to the office viewing location.

As shown in FIG. 7, if a user [71] in Room 1 (office, operating room,conference room, etc) wishes to contact a user [72] in Room 2 (office,operating room, conference room, etc), then user [71] initiates aconnection to Room 2 by accessing a web session on a PC [73]. User [71]selects the target room (Room 2 in this case) via the web interface,which is hosted on the Streaming Control Server [74] via Ethernet switch710. The application software running on the server [74] initiates thefollowing sequence of events:

-   -   1. A message is sent to the Video Decoder [76] in room 2.    -   2. The Video Decoder [76] is set to select and decode the video        and/or audio stream from the Video Encoder [75] in room 1, as        acquired from one or more cameras 712 or microphones 711.    -   3. A message is sent to the Video Decoder [78] in room 1.    -   4. The Video Decoder [78] is set to select and decode the video        stream from the Video Encoder [77] in room 2, as acquired from        one or more cameras 712 or microphones 711.

A point-to-point, bi-directional audio/video communication channel hasbeen established once this sequence is completed. The Streaming controlserver 74 tracks the usage of the resources for the session, and freesthem either based on an automatic timeout, or when the user logs offfrom the session.

The power of combined video and audio as communication mediums in ahospital environment is well understood. In the hospital environment,there are many other types and forms of information that can becollected and delivered in conjunction with the video to the viewingpoints throughout this digital infrastructure. Along with the livevideo, users of the system have expressed a strong desire to view othercategories of information, such as room state, patient status, and staffpresent in the OR.

Since digital video streams are being employed between the operatingroom and the plurality of viewing locations (ORs, Offices, Conferencerooms), we are able to enrich the information that is being sent, byadding digital metadata content. There are many types of metadata thatcan be collected. There are many ways that the data can be collected anddistributed. FIG. 8 is a diagram of two representative ways thatmetadata can be distributed within the system, and two ways that it canbe viewed. In the operating room or clinic (81), there are many sourcesof clinically relevant information (82) that can be harvested anddistributed. Some examples of this information are: patient information(e.g. DOB, vitals), operating room state, and staff. This information iscollected either locally or centrally by a network based softwareservice (83).

The information is persisted to a data store for later use when casedocumentation is reviewed and edited. The information is alsodistributed in real-time, or near real-time via connections (86, 87) toinformation consumers. The consumers may subscribe to some or all of theavailable information in the data stream. Information may be receiveddirectly as a digital metadata stream by smart displays and videodecoder devices (88, 89), where it is mixed with incoming digital videostreams. Information may also be received by computers, which host webbrowsers and/or specialized software applications (810), which are ableto receive and display the digital metadata stream.

Metadata may also be mixed with video at (85), either by directlyoverlaying text and graphics into the video, or by using the closedcaptioning features of the MPEG video encoding standard. This enrichedvideo content may be viewed directly by consumers via displays (89) orapplications/web browsers (810).

It is important to note that collection and distribution of state andstatus information is critically useful to the OR staff. Storage of thismetadata state information in a synchronized fashion with the recordedaudio and video is an added benefit that can be used to assist doctorsand users with the review and editing of recorded video.

The system is a highly flexible and powerful digital communication andproductivity tool for the hospital operating room and clinicalenvironment. Use of digital video streaming video technology enablesviewing, conferencing and communications from virtually anywhere a datanetwork is available.

A plurality of communications scenarios may be addressed, such as:Unidirectional viewing from virtually any location (with or withoutaudio), with the advantages of remote device control and video selectioncapability.

Example 1: A user in one OR wishes to view video in another OR

Example 2: A user in an office wishes to view video from an OR

Example 3: A user or group in a conference room wish to view video froman OR.

Bidirectional viewing of video (with or without audio)

Example 1: Users in two ORs wish to communicate between ORs, usingbidirectional links.

Example: 2: Users in an OR and a conference room wish to communicatebetween locations.

A variety of end-point encoder/decoder/viewer configurations arepossible with this system. Examples include:

Computers may be used for encoding, decoding, and viewing.

Hardware encoder/decoder sets may be purchased from 3^(rd) partymanufacturers.

Cameras and microphones may be connected to encoder devices.

Digital cameras with streaming outputs may be used directly with thesystem.

Displays and speaker systems may be connected to decoder devices.

The described systems and methods thus provide streaming digital video,audio and metadata content from operating rooms to multiple remotelocations, and remote access and control of video sources withinoperating rooms for remote real-time viewing of surgical activity andinformation in multiple operating rooms.

1. A streaming managed medical video network system for enabling accesson a medical network to live video data captured from a plurality oflocations, the system comprising: at least one streaming deviceassociated with at least one medical treatment location of the pluralityof locations, wherein the at least one streaming device is configured toreceive live video data from at least one of a plurality of sourceslocated in the at least one medical treatment location and convert thedata received from the at least one source of the plurality of sourcesinto a network packet stream, wherein the at least one source of theplurality of sources comprises a medical video source that views aprocedure, the procedure comprising one of a surgical procedure, adiagnostic procedure, and a therapeutic procedure, performed at the atleast one medical treatment location, the at least one medical treatmentlocation having a plurality of medical video sources therein, theplurality of medical video sources being used during the procedure inwhich medical personnel are present at the medical treatment location; anetwork switch in communication with the at least one streaming device;and a streaming video control server that: (a) authenticates at leastone of a plurality of users to the managed streaming medical videonetwork system; (b) establishes a communication channel, thecommunications channel being configured to route each network packetstream from the at least one streaming device, via the network switch,towards the at least one user for enabling access by the at least oneuser to the network packet stream; (c) provides the network packetstream to the at least one user such that, once the at least one userhas been authenticated to the system, the at least one user can view thelive video data contained in the network packet stream; and (d) tracks astatus of the medical treatment location during one of the surgicalprocedure, the diagnostic procedure and the therapeutic procedure, thestatus of the medical treatment location comprising one of a room statusand a patient status; and wherein the at least one streaming devicecaptures video simultaneously with state and status metadatainformation, by collecting patient information from a network-basedsoftware service and transmitting patient information, which is overlaidonto the video as it is being viewed by the at least one user at aremote location.
 2. The system of claim 1 wherein the streaming serveris configured to enable access to privacy control for controlling flowof network packet streams captured from the at least one streamingdevice configured to receive live video data from by the plurality ofsources located in the at least one medical treatment location.
 3. Thesystem of claim 1 wherein the streaming server is further configured toinitialize and host at least one remote viewing session for the at leastone remote user; track usage of network resources by the session,including usage of video sources; and free the resources based on one ofa pre-defined timeout or users logging off from the sessions.
 4. Thesystem of claim 3 wherein the streaming server is further configured toperform audit logging services by tracking user interaction with thesystem.
 5. The system of claim 1 wherein the communication channelcomprises a uni-directional channel that enables view-only services forthe at least one user.
 6. The system of claim 1 wherein thecommunication channel comprises a bi-directional channel forcommunication between the at least one user and the at least one medicaltreatment location.
 7. The system of claim 6 wherein the communicationchannel is established by an application running on a streaming server.8. The system of claim 6 wherein the bi-directional channel isestablished between a first operating room and a second operating roomto route network packet streams between the first operating room and thesecond operating room.
 9. The system of claim 1 further comprising agraphical user interface (GUI) that allows a remote user to perform atleast one of: room selection, dynamic room change, video sourceselection, remote control of a video source, and dynamic change of videosources.
 10. The system of claim 1 wherein the network packet receivedfrom the source in the at least one medical treatment location containsmetadata, the metadata including clinically relevant informationcorresponding to a state of the at least one medical treatment location.11. The system of claim 10 wherein the metadata is persisted to a datastore.
 12. The system of claim 10 wherein the metadata is persisted witha video network packet to a data store.
 13. The system of claim 10wherein the metadata is displayed to the at least one user.
 14. Thesystem of claim 10 wherein the metadata is displayed with the networkpacket stream to the at least one user.
 15. The system of claim 10wherein the clinically relevant information includes at least one of: apatient status at the at least one medical treatment location, a statusof the at least one medical treatment location, a presence of staff atthe at least one medical treatment location, an identifier of themedical treatment location and a location of the source.
 16. The systemof claim 10 wherein the metadata includes one of patient vital signsinformation, date of birth of patient, patient anesthesia status,patient presence in an operating room, cut skin status and closing. 17.The system of claim 10 wherein the packet stream is stored with themetadata by directly overlaying the metadata into the packet stream. 18.The system of claim 17 wherein the metadata includes one of text andgraphics.
 19. The system of claim 10 wherein the packet stream is storedwith the metadata by closed captioning features of MPEG video encodingstandard as implemented by the streaming server.
 20. The system of claim1 further comprising: a video wall; and at least one decoder associatedwith the video wall and in communication with the network switch, the atleast one decoder configured to receive and decode network packetstreams routed by the streaming video server for display on the videowall, thereby enabling access to live videos captured from the pluralityof locations.
 21. The system of claim 20 wherein the video wall isconfigured to display data corresponding to at least one of theplurality of locations, the data comprising one of video, audio andmetadata corresponding to the at least one of the locations.
 22. Thesystem of claim 20 wherein the network packet streams routed to thevideo wall comprise at least two different network packet streams,respectively containing data captured from at least two differentsources in the at least one medical treatment location.
 23. The systemof claim 20 wherein the network packet streams routed to the video wallcomprise at least one network packet stream containing data captured byat least one streaming device at the at least one medical treatmentlocation and at least a second network packet stream containing datacaptured by at least a second streaming device at a second location ofthe plurality of locations.
 24. The system of claim 20 wherein thenetwork packet streams are synchronized with metadata includingclinically relevant information corresponding to a state of the at leastone medical treatment location.
 25. The system of claim 1, wherein thecommunication channel is further configured to provide for a multicastvideo distribution model such that a single network packet stream fromone of the plurality of locations is routed towards a plurality ofremote users for contemporaneous display, thereby providing forsubstantially real-time access by the plurality of remote users to thesingle network packet stream.
 26. The system of claim 1 wherein the atleast one streaming device is further configured to receive audiosignals and video signals associated with the at least one source andconvert the received audio signals together with the received videosignals into the network packet stream.
 27. The system of claim 1,wherein the plurality of locations comprises at least one of a pluralityof operating rooms and wherein, for each of the plurality of operatingrooms, the system further comprises: a video switch in communicationwith at least one video source located in the operating room and atleast one streaming device associated with the operating room; and aswitch controller configured to control the video switch.
 28. The systemof claim 27, wherein: the plurality of locations further comprises atleast one conference room, the conference room having at least onedecoder and at least one streaming device associated therewith; each ofthe plurality of operating rooms having at least one decoder incommunication with a respective video switch and configured for decodingnetwork packet streams; and a streaming server that is configured toprovide for point-to-point bi-directional video communications betweenthe at least one conference room and the plurality of operating rooms.29. The system of claim 27, wherein the streaming video server isfurther configured to provide for point-to-point bi-directional videocommunications between at least two of the plurality of operating rooms.30. The system of claim 1 wherein each of the plurality of locationscomprise a room in a hospital environment network.
 31. The system ofclaim 1 wherein each of the plurality of locations include one of: anemergency room (ER), an operating room (OR), a conference room, apathology lab, and an office.
 32. The system of claim 1 wherein all ofthe plurality of locations are within one room of a hospital environmentnetwork.
 33. The system of claim 1, wherein the at least one streamingdevice comprises at least one of: a standalone video encoder, astandalone video streamer, a video encoding and streaming computer, adigital streaming camera, and a camera processor.
 34. The system ofclaim 1, wherein the streaming video server is further configured toprovide a network-based remote control interface that enables operatingroom control systems associated with the plurality of rooms to createand control connections between at least one of the plurality of videosources, request creation of communications between the plurality ofoperating rooms, and communicate on the hospital data network.
 35. Thesystem of claim 1, wherein the streaming video server is furtherconfigured to provide user interface that enables selection between aview-only communications channel and bi-directional communicationschannel by at least one of: a remote user and a user of an operatingroom.
 36. The system of claim 1 further comprising a switch controllerthat determines a state of the at least one medical treatment locationand communicates the state of the at least one medical treatmentlocation through the communication channel.
 37. The system of claim 1wherein the streaming video control server determines a state of atleast one of the at least one streaming device at the at least onemedical treatment location, the source and the at least one medicaltreatment location based upon input from a remote location to performsystem diagnostics.
 38. A system for enabling bi-directional videocommunications among a plurality of operating rooms in a hospitalenvironment connected by a streaming video network, the systemcomprising: a streaming control server; a network switch incommunication with the streaming control server; and for each of theplurality of operating rooms: at least one video decoder incommunication with the network switch and at least one display device;and at least one streaming device in communication with the networkswitch and one of a plurality of video sources located in the operatingroom, wherein the at least one source of the plurality of sourcescomprises a medical video source that views a procedure, the procedurecomprising one of a surgical procedure, a diagnostic procedure, and atherapeutic procedure; wherein the streaming control server isconfigured to: (a) authenticate at least one of a plurality of users tothe managed streaming medical video network system; (b) establish abi-directional communications channel between a first operating room anda second operating room of the plurality of operating rooms uponreceiving a corresponding request by: transmitting a first messagetoward a video encoder associated with the first operating room;configuring the video encoder associated with the first operating roomto select and encode a video stream; transmitting a second messagetoward a video decoder associated with the second operating room; andconfiguring the video decoder associated with the second room to receiveand decode a video stream encoded by a video encoder associated with thefirst operating room; and (c) provide the network packet stream to theat least one user such that, once the at least one user has beenauthenticated to the system, the at least one user can view the livevideo data contained in the network packet stream; (d) track a status ofthe first operating room, the status of the first operating roomcomprising one of a room status and a patient status; and wherein the atleast one streaming device captures video simultaneously with state andstatus metadata information, by collecting patient information from anetwork-based software service and transmitting patient information,which is overlaid onto the video as it is being viewed by the at leastone user at a remote location.
 39. The system of claim 38, wherein thereceiving a corresponding request further comprises: transmitting athird message toward a video encoder associated with the secondoperating room; configuring the video encoder associated with the secondoperating room to select and encode a video stream; transmitting afourth message toward a video decoder associated with the firstoperating room; and configuring the video decoder associated with thefirst room to receive and decode a video stream encoded by a videoencoder associated with the second operating room.
 40. The system ofclaim 1 wherein the communication channel comprises a bi-directionalchannel arrangement for communication between the at least one user andthe at least one medical treatment location so that live video data istransmitted between the at least one user and the at least one medicaltreatment location.
 41. The system of claim 40 wherein thebi-directional channel arrangement comprises a first one-waycommunication channel from the at least one user to the at least onemedical treatment location and a second one-way communication channelfrom the at least one medical treatment location to the at least oneuser.
 42. The system of claim 1 further comprising at least anotherstreaming device associated with at least another of the plurality oflocations, the at least one streaming device such that a bi-directionalcommunication channel arrangement is established by the streaming videocontrol server between the at least one medical treatment location andthe at least another location.
 43. The system of claim 1 wherein thestreaming video control server monitors the communication channel bycontrolling user access to the communication channel.
 44. The system ofclaim 1 wherein the streaming video control server controls thecommunication channel by regulating user access to the communicationchannel in support of HIPAA compliance.
 45. The system of claim 1wherein the streaming video control server further monitors thecommunication channel once the communication channel has beenestablished to track access to the communication channel.
 46. The systemof claim 1 wherein the streaming video control server authenticates theat least one of a plurality of users to the managed streaming medicalvideo network system by one of a log-in page and a username andpassword.
 47. The system of claim 1 wherein the streaming video controlserver authenticates the at least one of a plurality of users to themanaged streaming medical video network system so that the user isgranted access to live video data.
 48. The system of claim 38 whereinthe streaming control server is further configured to monitor thecommunication channel once the communication channel has beenestablished to track access to the communication channel.
 49. The systemof claim 1 wherein the status of the medical treatment locationcomprises at least one of: an operating room status, a privacy status ofthe medical treatment location, a patient presence in the medicaltreatment location, a staff presence in the medical treatment location,a patient anesthesia status in the medical treatment location, a cutskin status at the medical treatment location, a status of the at leastone streaming device and a presence of the at least one streamingdevice.
 50. The system of claim 1 wherein the status of the medicaltreatment location comprises a privacy status of the medical treatmentlocation.
 51. The system of claim 1 wherein the communication channelcomprises a TCP/IP network.
 52. The system of claim 1 wherein thestreaming video control server additionally tracks an overall state ofthe medical treatment location.
 53. A streaming managed medical videonetwork system for enabling access on a medical network to live videodata captured from a plurality of locations, the system comprising:means for receiving live video data from at least one source of aplurality of sources located in at least one medical treatment location,wherein the at least one source of the plurality of sources comprises amedical video source that views one of a surgical procedure, adiagnostic procedure, and a therapeutic procedure, performed at the atleast one medical treatment location; means for converting the livevideo data received from the at least one of the plurality of sourcesinto a network packet stream; means for authenticating at least one of aplurality of users to the managed streaming medical video networksystem; means for directing each network packet stream through acommunication network towards the at least one user for enabling accessby the at least one user to the network packet stream; means fortracking a room status of the medical treatment location during one ofthe surgical procedure, the diagnostic procedure and the therapeuticprocedure; means for providing the network packet stream and the roomstatus of the medical treatment location to the at least one user suchthat, once the user has been authenticated to the managed streamingmedical video network system, the at least one user can view the livevideo data contained in the network packet stream and the room status ofthe medical treatment location; and means for capturing videosimultaneously with state and status metadata information, by collectingpatient information from a network-based software service andtransmitting patient information, which is overlaid onto the video as itis being viewed by the at least one user at a remote location.
 54. Thesystem of claim 53 wherein the room status comprises at least one of: anoperating room status, a privacy status of the medical treatmentlocation, a patient presence in the medical treatment location, a staffpresence in the medical treatment location, a patient anesthesia statusin the medical treatment location, a cut skin status at the medicaltreatment location, a status of the at least one streaming device and apresence of the at least one streaming device.
 55. The system of claim53 wherein the room status comprises a privacy status of the medicaltreatment location.
 56. The system of claim 53 further comprising meansfor tracking an overall state of the medical treatment location.
 57. Thesystem of claim 1 wherein the medical treatment location comprises anoperating room and the room status comprises an operating room statusthat is collected from a network based software service.
 58. The systemof claim 57 wherein the operating room status is synchronized with thenetwork packet and delivered to remote users.
 59. The system of claim 1wherein medical personnel at the medical treatment location controlaccess to the plurality of medical video sources at the medicaltreatment location that provide security control to assist the medicaltreatment location in being HIPAA compliant.
 60. The system of claim 59wherein the at least one user is granted access via the communicationchannel to control the at least one streaming device in the medicaltreatment location, wherein the at least one streaming device comprisesa controllable operating room camera.
 61. The system as set forth inclaim 28 wherein the operating room video decoder is controlled to showa current state of the medical treatment location.
 62. The system as setforth in claim 61 wherein the current state comprises privacy modeenabled.
 63. The system as set forth in claim 61 wherein the currentstate comprises using microscope.
 64. The system as set forth in claim 1wherein the at least one streaming device captures video simultaneouslywith state and status metadata information, by collecting patient vitalsigns information from a network-based software service and transmittingpatient vital signs information, which is overlaid onto the video as itis being viewed by the at least one user at a remote location.